Understanding tobacco use and cessation challenges amongst patients with lung cancer: Elucidating demographics and the role of social networks.

Abstract

e22612 Background: Continued use of combustible tobacco after lung cancer diagnosis leads to worse morbidity and mortality. Unfortunately, smoking prevalence remains high amongst cancer patients and survivors. Interventions to improve cessation rates have been largely unsuccessful. A starting point to designing an optimal cessation program is to understand the demographics and circumstances these patients are exposed to. Methods: We designed a three-page anonymous questionnaire to gain more information about patients' past and current tobacco use history, level of nicotine dependence, assessment of motivation to quit, and their social network. Patients diagnosed with lung cancer and reported tobacco use at some point in their life were included. Study was granted an exempt status by IRB. Questionnaires completed between June 2022 and December 2023 were included. Descriptive statistics were used to analyze and report results. Results: Of the 200 respondents, 90 reported using tobacco at the time of cancer diagnosis. Among these, 52 patients reported continued use after diagnosis, while 38 quit. The mean age of individuals who continued to smoke was 72.9 years (SD 11.0) compared to 67.9 years (SD 10.3) for those who quit (p = 0.031). Continued users had a longer history of tobacco use, with median duration of 45.1 years compared to 30.8 years for those who quit (p < 0.0005). 34 (65.4%) of continued users had a partner who also used tobacco, with a median duration of being together of 30 years, compared to 16 (42.1%) and 22 years respectively for those who quit (p = 0.041). Household income, gender, race, family structure, marital status, and age at start of tobacco use were similar in both groups. Among those who reported quitting after cancer diagnosis, 50% had quit only within three months of the survey. 28 (53.8%) patients reported increased motivation to quit post-diagnosis, while others experienced decreased or no change. Barriers to quitting included stress, a desire to maintain control, and skepticism about the direct link between tobacco use and cancer. Only 5 (6.9%) patients were enrolled in a tobacco cessation program. Conclusions: This study provides valuable insights into the characteristics and motivations of individuals who continue using tobacco after a cancer diagnosis. The cohort's diverse demographics underscores the need for personalized support strategies. Family and social networks play a significant role in tobacco use behavior and should be considered in designing cessation programs. Multivariate analysis indicated that age, intensity of tobacco use (pack years), and having someone in the social network who uses tobacco were significant factors influencing continued use. Tailored interventions that consider these factors could potentially improve cessation rates and overall patient outcomes.